Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Ohio for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Ohio only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Ohio (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Marcello Gomes (NPI 1356489132)

Marcello Gomes is a cardiovascular disease physician provider located in Cleveland, Ohio. This profile covers 17 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Marcello Gomes
Address	9500 Euclid Ave
City	Cleveland
State	OH
ZIP	44195
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	February 2, 2007

Payer Source	Total Paid
Medicare	$42.2K
Medicaid	$0

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	140	$70	$10K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	70	$90	$6.1K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	40	$120	$5.2K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	180	$30	$4.8K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	180	$30	$4.5K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	50	$60	$3.1K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	50	$40	$2.1K
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	30	$40	$1.3K
93971	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arm or leg). This is a unilateral or limited…	90	$20	$1.3K
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	90	$10	$790

Showing 1–10 of 17

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	7,454	20,010	100	$70	$11.7K
99213	12,630	20,000	70	$50	$6.6K
99204	1,355	8,330	30	$100	$4.4K
99205	416	2,130	20	$140	$4.2K
93880	69	530	40	$50	$3.7K
93970	49	520	40	$40	$3.1K
99203	1,605	6,380	30	$60	$2.9K
93925	112	190	20	$60	$2.3K
93971	151	610	40	$30	$1.9K
93978	93	120	30	$40	$1.6K

Marcello Gomes — Billing Profile & Reimbursement Data

Sign up for Marcello Gomes — Billing Profile & Reimbursement Data policy alerts

Marcello Gomes — Billing Profile & Reimbursement Data

Sign up for Marcello Gomes — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References